DESCRIPTION: (Applicant's Description) This application seeks the competitive renewal of an R-25 grant-funded project whose long-term goals are to design, implement, evaluate and institutionalize comprehensive program of hospice and palliative care education at the University of Maryland School of Medicine for medical students and physicians (residents and faculty), and to integrate modern hospice and palliative care practices within the University of Maryland medical academic treatment and educational centers. The need to achieve these goals is great, since hospice and palliative care are neglected areas in the training of physicians. Prior to the initiation of our efforts in September 1994, only very minor teaching elements pertinent to the care of dying patients were in place in the medical school curriculum. In the last funding period we defined the terminal and enabling objectives of an educational program in hospice and palliative care for our medical students. Integration of this program as a required element at our medical school can best be accomplished by placing new content in the Freshman and Junior year. However, critical program objectives remain to be integrated and evaluated in the Junior year. We have also implemented educational sessions on palliative medicine for residents in Family Medicine and Internal Medicine and have created a successful annual series of symposia for Baltimore area physicians on the care of dying patients. To continue the development and integration of the educational programs for the next funding period, we propose to focus on the medical school curriculum, and have identified the following specific aims; 1) to complete the integration of our educational program in palliative medicine and hospice in the University of Maryland School of Medicine curriculum by developing, implementing, evaluating and institutionalizing in the Junior year a required didactic and practicum rotation in hospice and implement a plan for the long-term evaluation of the education program in palliative medicine that was placed in the University of Maryland medical school curriculum to determine the retention of the program goals by Senior students and graduates.